1. Technical Field
The present disclosure relates to methods and systems for the application of a surgical mesh. More particularly, the present disclosure relates to systems and methods for the in situ application of a hernia mesh during minimally invasive surgery.
2. Background of Related Art
Meshes are used during both laparoscopic and open surgery for repair of many types of defects and or injuries. For example, surgical meshes are used as catheter and cannula cuffs, for vascular anastomosis reinforcement, as wound dressings, for chest wall closure, as urinary incontinence slings, and for repair of hernias. Surgical meshes are used to provide support to surrounding tissue and as a supplement to standard suturing.
Hernias that appear at the site of a prior surgical incision or due to a defect in the abdominal wall are often called ventral hernias. Ventral hernias typically occur when an organ protrudes through the muscular wall holding organs in place, often at the site of a previous incision. Any prior abdominal operation, where there is incomplete scar formation or healing of the tissue, may develop a ventral hernia.
Ventral hernias occur more commonly along a straight line from the xiphoid process of the breastbone down to the pubic bone, and are more complex in these regions. Ventral hernias in this area have a high rate of recurrence if repaired via a simple suture technique under tension. For this reason, it is especially advised that ventral hernias be repaired via a tension free repair method using a mesh.
Open surgical repairs of ventral hernias may be difficult and complicated operations. The weakened tissue of the abdominal wall is re-incised and during repair the weakened tissue may be reinforced using a prosthetic mesh. The large incision required to perform this surgery may lead to complications, such as infection. In addition, large incisions required for open repair are commonly associated with significant postoperative pain.
Minimally invasive surgery for ventral hernias has shown several benefits including quicker recovery and shorter hospital stays, as well as a significantly reduced risk of infection and hernia recurrence. These benefits are due to both the smaller incision size and the reduced amount of time required to perform the surgery as compared to open surgery.
Whether open or minimally invasive, the use of trans-abdominal suture knots and tacks to secure the mesh to the tissue may create significant postoperative pain. In the case of trans-abdominal sutures, the suture is sub-fascially knotted in place. These sub-fascial knots may be a significant source of post operative pain. At times, the sub-facial knot may be located over abdominal nerves causing additional pain. Therefore, methods and systems for reducing surgical time and use of sub-fascial knots or tacks are needed.